Youth Ministry Registration St. Katherine Youth Program Registration Saint Katherine Greek Orthodox Church - Youth Ministry Registration Stewardship Number*Don’t remember your stewardship number? No problem, contact the church office at 310-540-2434 (M-F 9am-5pm). Not yet a member? Please click NEW STEWARD and complete an online pledge card with your first stewardship contribution. Welcome to St. Katherine’s Youth Program registration. Please complete ALL information for EACH CHILD you wish to enroll. Check boxes of ALL programs your child wishes to join. All students will be automatically registered for Sunday School and their grade appropriate Youth Ministry program (Budding Angels, Little Lambs, Hope, & Joy, Jr. GOYA, and Sr. GOYA)Fathers Info:Name First Last Email* Preferred Phone:*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Mothers Info:Name First Last Email* Preferred Phone*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Parent Volunteers Needed!Would you like to Volunteer?*YesNoWhich groups would you like to Volunteer for? Select All Sunday School (ages 2-18) Basketball (ages 11-18) Greek School Greek Dance School (age 7-18) Childs Info:Please enroll my child in the following groups* Select All Sunday School SKY Youth Ministry Altar Service Basketball Greek Dance School Youth Choir Greek Language School Child #1 Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneDate of Birth* Date Format: MM slash DD slash YYYY Grade LevelNot Yet AttendingPreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeTrade School/CollegeHealth InsuranceGroup and/or Policy NumberHealth History Frequent Ear Infections Heart Defect/Disease Diabetes Bleeding/Clotting Disorders Mononucleosis Asthma Chicken Pox Measels German Measels Mumps Hypertention Other: Please Explain*Allergies/Special Needs Hay Fever Poison Oak Insect Stings Foods Penicillin Special Needs/Learning Challenges Other Drugs Other Which Foods?*What Special Needs/Learning Challenges?*What Other Drugs?*Other*Emergency Contact Info:Emergency Contact* First Last Emergency Contact Phone*Other Emergency Contact First Last Other Emergency Contact PhoneWould you like to register another child?*NoYes Does this Child have the same parents as the child registered on the previous page?Yes (Same Mother and Father)No (Same Mother)No (Same Father)Fathers Info:Fathers Name First Last Email* Preferred Phone:*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Mothers Info:Name First Last Email* Preferred Phone*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Childs Info:Name First Last Please enroll my child in the following groups Select All Sunday School SKY Youth Ministry Altar Service Basketball Greek Dance School Youth Choir Greek Language School Address* Same as previous child Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneDate of Birth* Date Format: MM slash DD slash YYYY Grade LevelNot Yet AttendingPreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeTrade School/CollegeHealth InsuranceGroup and/or Policy NumberHealth History Frequent Ear Infections Heart Defect/Disease Diabetes Bleeding/Clotting Disorders Mononucleosis Asthma Chicken Pox Measels German Measels Mumps Hypertention Other: Please ExplainAllergies/Special Needs Hay Fever Poison Oak Insect Stings Foods Penicillin Special Needs/Learning Challenges Other Drugs Other Which Foods?What Special Needs/Learning Challenges?What Other Drugs?OtherEmergency Contact Info:Are the Emergency Contacts the same as previous?YesNoEmergency Contact* First Last Emergency Contact Phone*Other Emergency Contact First Last Other Emergency Contact PhoneWould you like to register another child?NoYes Does this Child have the same parents as the child registered on the previous page?Yes (Same Mother and Father)No (Same Mother)No (Same Father)Fathers Info:Fathers Name First Last Email* Preferred Phone:*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Mothers Info:Name First Last Email* Preferred Phone*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Childs Info:Name First Last Please enroll my child in the following groups Select All Sunday School SKY Youth Ministry Altar Service Basketball Greek Dance School Youth Choir Greek Language School Address* Same as previous child Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneDate of Birth* Date Format: MM slash DD slash YYYY Grade LevelNot Yet AttendingPreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeTrade School/CollegeHealth InsuranceGroup and/or Policy NumberHealth History Frequent Ear Infections Heart Defect/Disease Diabetes Bleeding/Clotting Disorders Mononucleosis Asthma Chicken Pox Measels German Measels Mumps Hypertention Other: Please ExplainAllergies/Special Needs Hay Fever Poison Oak Insect Stings Foods Penicillin Special Needs/Learning Challenges Other Drugs Other Which Foods?What Special Needs/Learning Challenges?What Other Drugs?OtherEmergency Contact Info:Are the Emergency Contacts the same as previous?YesNoEmergency Contact* First Last Emergency Contact Phone*Other Emergency Contact First Last Other Emergency Contact PhoneWould you like to register another child?NoYes Does this Child have the same parents as the child registered on the previous page?Yes (Same Mother and Father)No (Same Mother)No (Same Father)Fathers Info:Fathers Name First Last Email* Preferred Phone:*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Mothers Info:Name First Last Email* Preferred Phone*Can we text you at this number? No Yes Alternate PhoneCan we text you at this number? No Yes Childs Info:Name First Last Please enroll my child in the following groups Select All Sunday School SKY Youth Ministry Altar Service Basketball Greek Dance School Youth Choir Greek Language School Address* Same as previous child Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneDate of Birth* Date Format: MM slash DD slash YYYY Grade LevelNot Yet AttendingPreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeTrade School/CollegeHealth InsuranceGroup and/or Policy NumberHealth History Frequent Ear Infections Heart Defect/Disease Diabetes Bleeding/Clotting Disorders Mononucleosis Asthma Chicken Pox Measels German Measels Mumps Hypertention Other: Please ExplainAllergies/Special Needs Hay Fever Poison Oak Insect Stings Foods Penicillin Special Needs/Learning Challenges Other Drugs Other Which Foods?What Special Needs/Learning Challenges?What Other Drugs?OtherEmergency Contact Info:Are the Emergency Contacts the same as previous?YesNoEmergency Contact* First Last Emergency Contact Phone*Other Emergency Contact First Last Other Emergency Contact PhoneNameThis field is for validation purposes and should be left unchanged.
